Q: Dr. Eppley, I am having a tummy tuck and liposuction and am concerned about the risks of a deep vein thrombosis (DVT) and pulmonary embolism. (PE) Do you ever prescribe blood thinners in addition to sequential compression devices (scds) for the legs? I likely am being overly cautious but as a nurse who audits charts all day long I see DVTs and PEs as common problems in the hospital.
A: The prevention of DVTs is of utmost importance in any procedure but particularly in women who are having abdominal/pelvic surgery, which is a higher risk group. During any plastic surgery procedure and in recovery SCDs are used. After surgery early mobilization/ambulation is encouraged. A tummy tuck with or without liposuction is not a procedure one wants to lay around for any extended period of time. Fortunately, I have yet to have a DVT in a tummy tuck patient. Because of the increased risk of bleeding and hematomas, any form of blood thinner (such as heparin or lovenox) is not used unless the patient is a known risk with a prior history of DVT or a diagnosed abnormal blood hypercoagulopathy.
It is important to recognize that a hospitalized patient with a medical problem is a different situation than an otherwise healthy person having elective plastic surgery…so this would explain the dramatic difference in incidence of DVTs in these two populations. But they can happen in any surgery patient so SCDs and early ambulation are the established standard of care in tummy tuck patients.
Dr. Barry Eppley